Associations of metacognition and internalized stigma with quantitative assessments of self-experience in narratives of schizophrenia

Abstract 

Observations that diminishment of self-experience is commonly observed in schizophrenia have led to the suggestion that the deepening of self-experience may be an important domain of recovery. In this study we examined whether internalized stigma and deficits in metacognition are possible barriers to the development of richer self-experience. Narratives of self and illness were obtained using a semi-structured interview from 51 persons with schizophrenia spectrum disorder before entry into a rehabilitation research program. The quality of self-experience within those narratives was rated using the Scale to Assess Narrative Development (STAND). These scores were then correlated with concurrent assessments of stigma using the Internalized Stigma of Mental Illness Scale (ISMIS) and metacognition using the Metacognition Assessment Scale (MAS). A stepwise multiple regression controlling for age, social desirability and awareness of illness revealed that higher STAND ratings were significantly associated with greater ratings of metacognitive capacity and lesser ratings of stereotype endorsement. Results suggest that qualities of self-experience expressed within personal narratives of schizophrenia may be affected by internalized stigma and deficits in the capacity to think about one's own thinking and the thinking of others.

Keywords: Schizophrenia, Recovery, Stigma, Narrative, Metacognition, Insight